Essential guide: Inpatient care vs outpatient care UK

‘Inpatient care’ and ‘outpatient care’ are two terms you’ll regularly come across when reading about health insurance.

Whether you’re receiving treatment from the NHS or privately, all medical treatments can be classified as one or the other so it’s important to be clear on the distinction!

We’ve created a jargon-busting guide on the issue of inpatient care vs outpatient care in the UK, offering clear definitions and tips on how to include one or both in a healthcare plan. 

Get FREE one-to-one advice on how to invest in a cost-effective business health insurance plan from our team of experts on 01273 974419 or click on the right chat box. We’re here to answer all your questions and deliver the best quotes available in the market today.


What is inpatient care? 

Inpatient care is where a patient is admitted to hospital and has to occupy a bed for at least one night. Think of it as ‘patient-in-hospital’. A typical health insurance plan includes inpatient care in the policy. 

Typical inpatient treatments costs covered on a private healthcare scheme include: 

  • Surgery 
  • Private hospital accommodation costs
  • Medical tests 
  • After care 
  • Drugs/dressings 
  • Specialist fees
  • Anaesthetic fees 
  • Prosthesis 
  • Cancer drugs and biological therapies 
  • Diagnostic tests / scans 

Fees that have been incurred in hospital are covered by the insurer as long as the condition or procedure is eligible in the terms of your plan. For example, treatment for a health condition which pre-dates the start of the insurance policy will usually be excluded on the plan. 


What is outpatient care? 

Outpatient care refers to appointments and treatments which do not require you to occupy a hospital bed. Outpatient care is often excluded within healthcare policies, but they can be added onto a policy – though this will of course raise the premium.

If included, limits can be applied so it’s important to check through the details of your plan to understand which outpatient treatments are covered and to what degree. 

Outpatient services can include: 

  • Consultations with specialists 
  • Diagnostic tests e.g., blood tests, X-rays 
  • Diagnostic scans e.g., MRI, PET, CT
  • Radiotherapy / chemotherapy 
  • Physiotherapy 
  • Chiropractic 
  • Psychiatric / mental health services 
  • Annual check-ups  


What about day-patients?

Some treatments may require patients to occupy a hospital bed for a few hours, rather than overnight. These cases are often included as an inpatient treatment, as the form of treatment undertaken is typically covered under inpatient services. Often a doctor will make a judgement on the day as to whether a patient is required to stay overnight or not – and so it would be rather unfair if this judgement affected the insurance payout!


Is outpatient care covered by health insurance?

Most standard policies only cover inpatient care and treatments, but outpatient services can also be included at an additional cost. However, some insurers might already include outpatient care in their offerings but with a set of parameters and limits involved, only letting your staff to be covered up to a particular cost amount. For example, if the outpatient cost care exceeds the specified amount, costs will incur outside of the policy either to end up using the NHS services going into your own pockets. 


Inpatient vs outpatient care: what’s the difference? 

Inpatient care is when a patient must stay in hospital overnight for treatment. Outpatient care, on the other hand, is when a patient receives treatments and services without requiring hospitalisation… wait, is it as simple as this? 

In short, the answer is it can be that simple! But it’s important to consider the differences in those two types of care and the difference in pricing.  

Inpatient care:

  • Patient admitted to hospital for at least 24 hours for treatment 
  • Complex/major surgeries 
  • Treatment of traumatic injuries 
  • Specialist treatment and observation 
  • Expensive costs – includes facility-based charges and medical fees, administrative costs etc 

Outpatient care: 

  • Patient not required to stay in hospital for treatment 
  • Minor surgeries 
  • Same day emergency service 
  • Specialist consultations, bloodwork, diagnostic tests 
  • Cheaper costs – involved only the cost of tests, staff fees, potentially medication costs too

Need free advice and support from a health insurance broker? Contact our award-winning team on 01273 974419 or click on the right chat box. We’re happy to answer all queries to deliver the perfect insurance schemes for your staff. 


Is there anything not included in inpatient/outpatient cover? 

As for any health insurance plan, there are certain procedures and treatments that are not included in either inpatient or outpatient cover. 

  • Chronic conditions 
  • Routine pregnancy 
  • Congenital conditions 
  • Accident and emergencies 
  • Planned overseas treatments 
  • IVF and infertility treatments 
  • Cosmetic treatments 

However, some specialist health insurance policies may assist in some of these areas. For example, International Health Insurance policies (a single policy designed to cover multiple countries) typically includes more health services than a regular UK health insurance policy.


Should I invest in inpatient cover AND outpatient cover? 

While inpatient care comes as standard, outpatient services are an added-extra certainly worth serious consideration. Outpatient care is very useful for everyday health needs and can ensure that you access medical help at speed. On the other hand, if you have relatively straightforward access to NHS services, then the extra investment in your private healthcare package might be a needless expense. 

For businesses, it’s worth noting that the demand for outpatient cover is growing due to lengthening NHS waiting lists in many areas and rising living costs and higher demand for mental health support.


Is a Health Cash Plan a worthwhile alternative?

It certainly is for individuals and businesses who want to prioritise support for everyday healthcare needs. A Health Cash Plan excludes the more ‘dramatic’ health interventions provided by a regular health insurance policy and instead covers only routine health support such as: 

  • Eyecare
  • Dental check-ups & treatment
  • Health assessments/screenings
  • Physiotherapy
  • Osteopathy
  • Acupuncture
  • Chiropractor
  • Hearing aids
  • Prescriptions
  • Counselling 
  • Homeopathy

Because Health Cash Plans only focus on routine health support, they cost less than a regular private health plan.


Importance of seeking advice 

Now that you understand the difference between inpatient and outpatient care you’ll have a better idea of what’s included in a policy. If you’re a business in need of extra help, then why not employee the services of an independent and award-winning broker?

Engage Health Group will talk you through your options and  gather a variety of quotes from across the market and ensure you have the perfect combination of health coverage and employee benefits – all supplied within budget. 

Our services come at no extra cost to your businesses. This means you get FREE specialist support in negotiating with insurance companies and ongoing access to independent advice you can trust. 

Contact us at [email protected] or call +44 (0)1273 974419 for FREE no-obligation advice and support.

Eleanor Chilvers

Eleanor Chilvers

Eleanor started at Engage in 2021, and is now a Digital Content Writer after studying BA English Literature at University of Sussex for the last 3 years.

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